Clinical observation on critically ill patients where Sohu deputy director Li Bin health, No.306 Hospital of Chinese PLA, how to do the heavy ward patient and health care medical department, the observation is a system engineering, from the symptoms and signs, from the physical to mental and psychological, the patient as a whole were observed carefully. Always and throughout the course of the disease. Therefore, nurses should be familiar with the contents of the observation of the disease, and constantly strive to develop their own sense of purpose, the initiative to observe the disease. To observe the conditions of disease significance and nursing staff, the observation should have the process that nursing staff actively start visual and hearing, smell, touch and other sensory organs and auxiliary tools to obtain relevant information of the patients and their situation. The observation must be prudent and conscious, and it is a continuous process, not a temporary or accidental activity. Through observation, timely detection of the patient’s condition changes, and provide appropriate treatment and nursing measures to promote the recovery of patients as soon as possible. The nursing staff of a skill and ability, must always observe, and can alert, keen reaction in a proper way. This requires the nurse must have extensive medical knowledge, rigorous work style, strict in demands, high responsibility and trained with regularity observation ability, do the "five Qin", namely: Qin, Qin, Qin patrol inspection inquiry, diligent, attendance record. Through a purposeful, planned and careful observation, timely and accurate grasp or foresee changes in the condition, to win time for the rescue of critically ill patients. Two, observation of illness condition is the premise of nursing critical patients. (a) the 1 faces of the general situation: acute tolerance, patients showed facial flushing, shortness of breath, nervous, chapped lips, facial pain, fever in acute patients; chronic patients, showed pale or dark, gaunt and the spirit of the apathetic, glassy eyes, found in pulmonary tuberculosis malignant tumor, chronic obstructive pulmonary disease patients. Typhoid apathetic, unresponsive, we called it "apathy"; tetanus patients showed trismus due to hyperthyroidism patients for fear of wry face; face etc.. 2 diet and nutrition. 3 position and position. 4 skin and mucous membranes. 5 rest and sleep. 6 vomiting. 7 fecal matter. (two) changes in vital signs of 1 temperature: temperature rise suddenly, more common in the acute infection of patients; the temperature lower than 35.O DEG C, in shock and extreme failure patients; persistent fever, high fever, body temperature continued to rise over expressed in serious condition. Change 2 pulse: should pay attention to changes in frequency, rhythm, strength of the pulse of the patient, such as pulse rate is less than 60 times per minute or more than 140 times per minute, and intermittent pulse, pulse deficit, veinlets, said the condition changes. 3 respiratory changes: should pay attention to observe the patient’s breathing frequency, rhythm, depth, sound, etc.. Such as the occurrence of respiratory frequency higher than 40 times / min or less than 8 times / minute, as well as tidal breathing